In this dyadic study, we examined diabetes distress experienced by male and female patients and their spouses (N = 185 couples), and its association with depressive symptoms using the Actor-Partner Interdependence Model. Diabetes-related distress reported by both patients and spouses was associated with each partner's own depressive symptoms (actor effects) but generally was not associated with the other's depressive symptoms (partner effects). Moreover, diabetes distress was associated with depressive symptoms more strongly for male than for female patients, but this association did not differ between female and male spouses. Findings underscore the dyadic nature of managing chronic illness in that disease-related distress was experienced by patients and by their spouses and consistently was associated with poorer affective well-being.